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Sunday, October 21, 2012

‘Short stay’ hip arthroplasty patients show good results

MANCHESTER — Researchers from the United Kingdom have reported positive results for a short stay hip program, which educates and then discharges patients within 2 days after an uncemented total hip arthroplasty procedure, according to a presentation here.

“Short length of stay is very achievable in the district general hospital setting,” Sebastian Dawson-Bowling, MCRS, stated in his presentation at the British Orthopaedic Association Congress, here. “These are highly reproducible steps and we believe the program can be reproduced elsewhere.”

Sebastian Dawson-Bowling

Of 100 patients evaluated at 3-year to 5-year follow-up, there was one dislocation, one myocardial infarction and one deep infection. Patients were mean 65 years old with an American Society of Anaesthesiologists (ASA) score of 1.97 and stayed for a mean of 1.99 nights. There was no association between ASA score and age, according to the abstract.

Patients underwent a half-day “joint school training” regime prior to admission, where they are assessed in a group session, followed by an individual physiological exam and assessment by nurses, Dawson-Bowling said. Prior to surgery, the patients received crutches for practice at home.

Surgeons performed a total hip arthroplasty using an uncemented implant
through a mini-posterior approach using low dose spinal and general anesthesia. Postoperatively, patients had access to outreach care, Dawson-Bowling said.

Dawson-Bowling said the ASA score and mean patient age were comparable to the national average. Of 82 patients under current follow-up, 97% remain satisfied with their implants, according to the abstract.